Department File Number : | M201677936 |
Claim Number : | 38-01-2015-0046A |
Date Submitted : | 4/14/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MOUNT SINAI MEDICAL CENTER | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-0624424 | 4066 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | NANCY | CARR | |||
Street Address | |||||
11440 SW 88th STREET | |||||
City | State | Zip | |||
MIAMI | FL | 33176 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Thomas | Mesko | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 4306 Alton Road, 2nd Floor | ||||
City | State | Zip Code | County | ||
Miami Beach | FL | 33140 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MSMCFGC-PR-A-15 MSMC16 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME62320 | Surgery - oncology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MOUNT SINAI MEDICAL CENTER | 100034 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/17/2015 | 9/9/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Poorly differentiated adenocarcinoma. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Elective esophagogastroduodenoscopy, diagnostic laparoscopy, laparotomy with gastrectomy and feeding jejunostomy tube. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis made of the patient's actual condition. | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. Notice of Intent was voluntarily withdrawn by the claimant's attorney during the presuit investigative period. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 3/14/2016 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $4,752 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $11,061 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Not applicable. |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. THOMAS MESKO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. THOMAS MESKO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).